A nurse who worked at Wales' busiest emergency department has described how she suffered more stress there than she did when she was on the front line in Iraq.
The no-holds-barred account of her working life at Cardiff's University Hospital of Wales was pinned to a noticeboard at the site - it was later read out at a meeting with senior managers.
The nurse, who spent six months in a field hospital in Iraq in 2003, told of how an expectant mother miscarried on the floor, a suicidal patient locked herself in the toilets and a woman suffered a suspected heart attack in the waiting area.
She told how the department was unable to cope with the amount of patients coming through the doors due to a lack of beds and experienced staff.
She wrote: "Our 10-bay resuscitation unit in Iraq was full most days of multiple traumas, gunshot wounds, explosive device injuries, children shot.
"I spent weeks in and out of the trenches being shelled, nursing soldiers under trolleys as the warning sirens went off.
"I know what stress is. I know what it is like to work under pressure and yet I can guarantee that the nurses with me in Emergency Unit today are facing higher levels of stress than we ever did in that war zone."
Tina Donnelly, director of the Royal College of Nursing in Wales, said the nurse's comments were "absolutely shocking" and "worrying".
She said: "This is a blow-by-blow account of a sister in an emergency unit demonstrating how complex and challenging working in emergency care is.
"All of these challenges relate to a need of staffing levels to be at their optimum level to deal with these complex care issues."
Health board officials said staff at all levels were working "tirelessly" to meet "extraordinary demand".
Adam Cairns, chief executive of Cardiff and Vale University Health Board, said the nurse "in no way" intended for the letter, which contains patient information, to be made public.
But he confirmed the nurse's story highlighting the "very real" challenges facing the unit.
